Provider Demographics
NPI:1417094541
Name:CATHOLIC HEALTH INITIATIVES IOWA CORP
Entity Type:Organization
Organization Name:CATHOLIC HEALTH INITIATIVES IOWA CORP
Other - Org Name:MERCY OSTOMY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF CENTRAL BILLING OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:LENZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-643-8727
Mailing Address - Street 1:PO BOX 14584
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50306-3584
Mailing Address - Country:US
Mailing Address - Phone:515-247-8133
Mailing Address - Fax:
Practice Address - Street 1:1111 6TH AVE
Practice Address - Street 2:WEST 1
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-2613
Practice Address - Country:US
Practice Address - Phone:515-643-0850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA44067Medicare PIN